MATTHEW GROENWALD MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****06

License Status

ACTIVE

Business

Title

First Name

MATTHEW

Last Name

GROENWALD

Business Name

MATTHEW GROENWALD MD

Original Issue Date

08/03/2019

Effective Date

06/14/2023

Expiration Date

07/31/2026

City

ROCKFORD

State

Zip

61114

County

BOONE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/14/2023